One of the most effective methods of protecting the health of young children is vaccination, and over the past few decades, remarkable strides have been made in the effort to vaccinate more children against illnesses that can prove fatal if contracted.

In many ways, thanks to the dogged commitment of a number of organizations involved in the field of global health and the resources they’ve devoted to the cause, this effort has been an enormous success. Across the world, in fact, millions of children who would have gone without in the past now receive vaccines that help prevent flu, diarrhea, tuberculosis, and pneumonia, among other diseases.

It’s something to celebrate, but at the same time, we can’t ignore the fact that some 22 million children still do not get vaccinated each year and are thus left vulnerable to sicknesses that halt young lives before they really get underway. Nor can we ignore the fact that the current pricing structures around vaccines, along with the dominant research and development models, are part of the reason this happens.

In this issue of Alert, we want to give an in-depth look at some of the dynamics that have prevented the international medical community from vaccinating more children and some of the changes that will be necessary if we are going to protect more of the most vulnerable among us.

This conversation relates to what is now a signature MSF issue: Access to medicines. It’s something that can be discussed in policy terms and through numbers and graphs, but on some level, we’re talking about what is possible, what could be done—who could be assisted—if the proper resources were allocated and the proper priorities established.

That’s what we see in the story of a young South African woman named Phumeza, whom you’ll also meet in these pages. She recently completed a grueling treatment program for multidrug-resistant tuberculosis and is now looking ahead to the next phase of her life.

Her accomplishment is something to be celebrated. But we, as caretakers, know that the pills she had to take—all 20,000 of them—could be better, that easier and perhaps faster and more effective TB treatments are possible. At the very least, they, like better-adapted and more affordable vaccines for children, should be pursued so more people can benefit—some 8.6 million people developed TB last year, according to the WHO, and 1.3 million died from it—and more lives can be fully lived.

We also bring you firsthand accounts from two MSF field workers recently returned from working in Syria, along with an op-ed about MSF’s wrenching decision to close its Somalia programs, both of which touch on the art of the possible from different angles. And we’re proud to share an excerpt from a recent World Policy Journal article by MSF’s Jason Cone and Francois Duroch on the risks humanitarian workers—and emergency medical workers in particular—face in the field.

We hope you will enjoy this issue of Alert, and hope you will continue to help us see what is possible in our work, and for our patients.